Provider Demographics
NPI:1891774048
Name:WOOD, RACHEL (DPM)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E CALAVERAS BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-7703
Mailing Address - Country:US
Mailing Address - Phone:408-263-8141
Mailing Address - Fax:408-263-4746
Practice Address - Street 1:500 E CALAVERAS BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-7703
Practice Address - Country:US
Practice Address - Phone:408-263-8141
Practice Address - Fax:408-263-4746
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-14
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE26400213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT11416Medicare UPIN
CA000E26400Medicare ID - Type Unspecified
P00335276Medicare PIN
4739880001Medicare NSC